Kleindorfer Dawn, Khoury Jane, Kissela Brett, Alwell Kathy, Woo Daniel, Miller Rosemary, Schneider Alexander, Moomaw Charles, Broderick Joseph P
Department of Neurology, University of Cincinnati College of Medicine, OH 45267-0525, USA.
J Child Neurol. 2006 May;21(5):415-8. doi: 10.1177/08830738060210050301.
A recent study reported that mortality from stroke in children and adolescents decreased by 58% from 1979 to 1998, although it wasn't clear if the case fatality or the incidence of stroke in this age group is decreasing. We report trends of stroke incidence and case fatality in children and adolescents within a large biracial population. The study involved collection of all strokes in the study population between January 1, 1988 and December 31, 1989, July 1, 1993 and June 30, 1994, and January 1, 1999 and December 31, 1999, at all of the regional hospitals serving the Greater Cincinnati/Northern Kentucky population (only the children's hospital in 1988). Study nurses reviewed the medical records of all inpatients with stroke-related discharge diagnoses and abstracted relevant data. A study physician reviewed each abstract to determine whether a stroke or transient ischemic attack had occurred. A total of 54 strokes occurred in children or adolescents younger than 20 years during the three study periods (30% African American, 70% Caucasian, and 56% female). The overall incidence rate of all strokes in children younger than 15 years was 6.4/100,000 in 1999, a nonsignificant increase when compared to 1988. The 30-day case-fatality rates were 18% in 1988-1989, 9% in 1993-1994, and 9% in 1999. We found that the incidence of strokes in children has been stable over the past 10 years. The previously reported nationwide decrease in overall stroke mortality in children might be due to decreasing case fatality after stroke and not decreasing stroke incidence. Based on our data, we conservatively estimated that approximately 3000 children less than 20 years old would have a stroke in the United States in 2004.
最近一项研究报告称，1979年至1998年间，儿童和青少年中风死亡率下降了58%，不过尚不清楚该年龄组中风的病死率或发病率是否在下降。我们报告了一个大型混血人群中儿童和青少年中风发病率及病死率的趋势。该研究涉及收集1988年1月1日至1989年12月31日、1993年7月1日至1994年6月30日以及1999年1月1日至1999年12月31日期间，为大辛辛那提/北肯塔基地区人群服务的所有区域医院（1988年时仅儿童医院）中研究人群的所有中风病例。研究护士查阅了所有出院诊断与中风相关的住院患者的病历，并提取了相关数据。一名研究医生复查了每份摘要，以确定是否发生了中风或短暂性脑缺血发作。在三个研究期间，共有54例中风发生在20岁以下的儿童或青少年中（30%为非裔美国人，70%为白种人，56%为女性）。1999年，15岁以下儿童所有中风的总体发病率为6.4/100,000，与1988年相比无显著增加。1988 - 1989年的30天病死率为18%，1993 - 1994年为9%，1999年为9%。我们发现，过去10年儿童中风发病率一直稳定。此前全国范围内报告的儿童总体中风死亡率下降，可能是由于中风后病死率降低，而非中风发病率下降。根据我们的数据，我们保守估计2004年美国20岁以下约有3000名儿童会发生中风。
